Frequently Asked Questions (FAQs) on Pneumococcal Vaccine

What is the Pneumococcal Vaccine?

Pneumococcal disease is a severe infection caused by Streptococcus pneumoniae bacteria that spreads from person-to-person through air. The disease can  cause pneumonia in the lungs, and can affect other parts of the body.

Pneumococcal vaccination is a significant preventive health care measure that reduces the burden of pneumococcal disease substantially in vaccinated people as well as the community. While it is a routine part of childhood immunization schedules across the world, pneumococcal vaccination is also indicated for adults with risk factors for pneumococcal disease or those with severe adverse outcomes should the disease occur.

Types of Pneumococcal Vaccinations

As per the CDC (Centers for Disease Control and Prevention), adults who are 65 and above should have two pneumococcal vaccinations –

1. Pneumococcal polysaccharide vaccine (PPSV23)

2. Pneumococcal conjugate vaccine (PCV13)

You can get either of the two above mentioned vaccines (but not  both) when you receive the flu vaccine. Talk to your doctor to find out when you should come back for the other pneumococcal vaccine.

What are the benefits of Pneumococcal Vaccination?

Pneumococcal polysaccharide vaccine (PPSV23)

Studies cited by CDC reveal 1 dose of PPSV23 vaccine protects

• About 50 to 85 in 100 healthy adult people against invasive pneumococcal disease

Pneumococcal conjugate vaccine (PCV13)

Studies cited by CDC show that at least one dose of pneumococcal conjugate vaccine protects

• 8 in 10 babies from severe infections known as invasive pneumococcal disease
• 75 in 100 adults aged 65 years or above against invasive pneumococcal disease
• 45 in 100 adults aged 65 years or above against pneumococcal pneumonia

In India, the burden of pneumococcal disease is  a major health concern. The pneumococcal disease incidence rates in India in the year 2018 were found to be:

1. 31.3 percent among people 60 years and above
2. 22.7 percent for people aged 44–60 years
3. 13.9 percent among adults aged 18–44 years

Therefore, the use of pneumococcal vaccine in India is worthwhile, as it does not just reduces the pneumococcal disease burden, but will also lead to a positive impact on healthcare economics by decreasing the overall health-care expenditure.

Who can get Pneumococcal Vaccination?

The CDC advises pneumococcal vaccination for all children below 2 years of age and all adults 65 years or above. In some situations, pneumococcal vaccines should also be given to other children and adults. Check below for more information about who should get each type of pneumococcal vaccine.

PPSV23 [ Pneumococcal polysaccharide vaccination]  is recommended

1. For all adults 65 years old or above
2. People 2 years of age through 64 years old with some medical conditions
3. Adults 19 years of age through 64 years old who smoke

PCV13 [Pneumococcal conjugate vaccination] is recommended for:

1. All children below 2 years of age
2. Individuals 2 years or above with certain medical conditions

However, talk to your or your child’s doctor about what is best suited for your specific situation.

Who cannot take Pneumococcal Vaccination?

Owing to age or health conditions, certain people should not get some vaccines or should wait before taking them.

Pneumococcal Polysaccharide Vaccine (PPSV23)

Children below 2 years should not get this vaccine. Also, tell the individual giving you or your child this pneumococcal polysaccharide vaccine if:

1. You or your child have severe allergy or have earlier had a life-threatening allergic reaction
2. Any person who previously had a life-threatening allergic reaction to PPSV23 vaccine should not take another dose.
3. Any person having severe allergy to any component of PPSV23 should not take it. Your doctor or your child’s doctor can inform you about the components of the vaccine.
4. You or your child are not feeling well

While any person having mild illness like can take the vaccine, those having more serious illness should perhaps wait till they recover. Your doctor or your child’s doctor may advise you.

• You are pregnant.

Although, there is no evidence that PPSV23 vaccine is harmful to either a pregnant woman or to her infant, however, as a precaution, women who need this vaccination should take it before becoming pregnant, if possible.

Pneumococcal Conjugate Vaccine (PCV13)

Inform the person who is administering you or your child a pneumococcal conjugate vaccine if:

1. You or your child have a severe allergy or have earlier had a life-threatening allergic reaction
2. Any person who have had a life-threatening allergic reaction to any of the following should not take PCV13:
3. A dosage of this vaccine
4. An previous pneumococcal conjugate vaccine known as Prevnar® or PCV7
5. Any vaccine having diphtheria toxoid (for instance, DTaP)
6. Any person with severe allergy to any component of PCV13 must avoid or should not get this vaccine. Your doctor or your child’s doctor can tell you about the components of the vaccine.
7. You or your child are not feeling well

While any person having mild illness like cold may perhaps take the vaccine, those with more severe disease should perhaps wait till they recover. Your doctor or your child clinician can advise you.

How is this vaccine administered?

The pneumococcal vaccine is administered as a single shot (injection) in adults. The vaccine is injected under the skin (SC or subcutaneous) or as a liquid solution (0.5 mL) into the muscle (IM or intramuscular), typically in the deltoid muscle.

How long will Pneumococcal Vaccination be effective?

Individuals aged 65 and above need only a single pneumococcal shot. Pneumococcal vaccine is not given annually like the flu vaccination. People with long-term health condition may need vaccination every 5 years or just a single one-off pneumococcal vaccination depending on their underlying health condition.

What are the potential Side Effects of Pneumococcal Vaccination?

With any medicine, which includes vaccines, there is a chance of some side effects. Majority of individuals who have taken pneumococcal vaccine did not show any severe side effects with it.

Mild Problems

Pneumococcal Conjugate Vaccine (PCV13)

Mild side-effects following PCV13 vaccination may include:

1. Reactions where the shot was administered
2. Redness
3. Swelling
4. Pain or tenderness
5. Fever
6. Loss of appetite
7. Irritability (fussiness)
8. Chills
9. Feeling tired
10. Headache

Ask your doctor for more information.

Pneumococcal Polysaccharide Vaccine (PPSV23)

1. Mild side effects following PPSV23 may include:
2. Reactions where the shot was administered
3. Pain
4. Redness
5. Muscle aches
6. Fever

If these side-effects occur, they generally go away within two days.

Talk to your doctor if you

• Have vision changes
• Feel dizzy
• Have ringing in the ears

• A few may experience severe pain in the shoulder and may have difficulty moving the arm where they received the shot. However, this happens very rarely.
• Any medication may cause a severe allergic reaction. However, such reactions from a vaccine are extremely rare – estimated at nearly 1 in a million doses. Such types of severe reactions would occur within few minutes to a few hours after the shot.
• Like medicines, there is a very remote chances of a serious injury or death from a vaccine.

What are the contraindications and precautions?

1. PCV13 and PPSV23 are contraindicated if the individual has hypersensitivity to any component of the vaccine
2. Both PPSV23 and PCV13 should not be given during acute respiratory illness
3. Caution should be exercised in individuals with altered immunocompetence (congenital or acquired splenic dysfunction, malignancy, HIV [human immunodeficiency virus] infection, nephrotic syndrome and hematopoietic stem cell transplant), including those at greater risk for invasive pneumococcal disease, as these individuals may have reduced antibody responses to immunization with the pneumococcal vaccine
4. Appropriate agents should be made available immediately if allergic reactions occur due to the vaccine
5. In the case of pregnancy, although not contraindicated, there is no recommendation regarding the use of PCV13. Even the use of PPSV23 during pregnancy is not specifically recommended, due to the lack of adequate safety data
6. The use of pneumococcal vaccine in solid-organ transplant recipients is not contraindicated. However, adequate data is lacking for a proper recommendation
7. Pneumonia vaccine is not contraindicated in rheumatoid arthritis patients

Is pneumococcal vaccination safe during this pandemic?

While the existing pneumococcal vaccination does not protect against COVID-19, it is recommended for protection against pneumococcal disease.

Experts strongly recommend of prophylactic pneumococcus vaccination in immunocompromised patients during the pandemic. However, for those with active COVID‐19 infection, the experts advise against concurrent pneumococcal vaccination and suggest that these individuals should be pre‐screened for symptoms and exposure before vaccination happens. In addition, doctors should consider local rates of COVID‐19 spread and refer to local guidelines for optimal timing of vaccination. 

Myths Associated with Pneumococcal Vaccination